Gadovist® is an extracellular, neutral macrocyclic (gadolinium (Gd) complex) MRI contrast agents for central nervous system indications, particularly suited for studies in which high doses are required or advantageous. Gadovist® (also Gadograf) was available in two concentrations, currently only Gadovist® 1.0 is marketed.
The product was approved in Switzerland in 1999 and in Germany in 2000. Gadovist® 1.0 is in USA currently in the drug development and approval process, particularly for magnetic resonance angiography.

WARNING: NEPHROGENIC SYSTEMIC FIBROSIS Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m²), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.

See also Paramagnetic Contrast Agents and Gadobutrol.

Generic name: Liposomes, central moiety: different, contrast effect: paramagnetic, distribution: different
Liposomes are lipid containing nanoparticles, or fat molecules, surrounding a water core. Liposomes were the first type of nanoparticles created to be used as carriers for lipophilic MRI contrast agents with novel characteristics.
Liposomes loaded with gadolinium-containing chelates have potential as blood pool agents, caused by modifications of the surface (e.g., with polyethylene glycol) leading to longer blood retention times.
The incorporation of contrast agents into either the the bilayer membrane or the aqueous inner cavity is possible. These MRI contrast agents has been used to image the lymph nodes using liposomes containing Gd-DTPA as well as dextran coated iron oxide particles.
To image the liver or the hepatobiliary system, liposomes containing Gd-HPDO3A, or MnDPDP, have been tested.
Liposomes containing gadolinium were conjugated to antibodies and targeted to a specific organ system.
A method of targeting tumors with ultrasound that also uses MRI to watch the cell destroying, uses liposomes loaded with cytotoxic drugs and also with gadolinium to make them show up in MRI. As well as used as an imaging technique, ultrasound can also be used to destroy cancer cells. Once the drugs have been administered, focusing the ultrasound on the target area makes blood vessels permeable. The liposomes leak out of the blood vessel into the target area, watched by MRI, where the cytotoxic drug can then go to work.

See also Memosomes, Superparamagnetic Iron Oxide, Classifications, Characteristics, etc. and Mangafodipir Trisodium.

Lung imaging is furthermore a challenge in MRI because of the predominance of air within the lungs and associated susceptibility issues as well as low signal to noise of the inflated lung parenchyma. Cardiac and respiratory triggered or breath hold sequences allow diagnostic imaging, however a comparable image quality with computed tomography is still difficult to achieve.
Assumptions for lung MRI:
The current trends in MRI are the use of new imaging technologies and increasingly powerful magnetic fields. Among these technologies are parallel imaging techniques as well as ventilation agents like hyperpolarized helium for the use as an inert inhalational contrast agent to study lung ventilation properties. With hyperpolarized gases clear images of the lungs can be obtained without using a large magnetic field (see also back projection imaging). Single shot sequences (e.g. TSE or Half Fourier Acquisition Single Shot Turbo Spin Echo HASTE) used in lung MR imaging benefits from parallel imaging techniques due to reduced relaxation time effects during the echo train and therefore reduced image blurring as well as reduced motion artifacts.
In the future, more effective contrast agents may provide an alternative solution to the need for high field MRI. Dynamic contrast enhanced MRI perfusion has demonstrated a potential in the diagnosis of pulmonary embolism or to characterize lung cancer and mediastinal tumors. 3D contrast enhanced magnetic resonance angiography of the thoracic vessel.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'

There are different types of contraindications that would prevent a person from being examined with an MRI scanner. MRI systems use strong magnetic fields that attract any ferromagnetic objects with enormous force. Caused by the potential risk of heating, produced from the radio frequency pulses during the MRI procedure, metallic objects like wires, foreign bodies and other implants needs to be checked for compatibility. High field MRI requires particular safety precautions. In addition, any device or MRI equipment that enters the magnet room has to be MR compatible. MRI examinations are safe and harmless, if these MRI risks are observed and regulations are followed.

Safety concerns in magnetic resonance imaging include:

It is important to remember when working around a superconducting magnet that the magnetic field is always on. Under usual working conditions the field is never turned off. Attention must be paid to keep all ferromagnetic items at an adequate distance from the magnet. Ferromagnetic objects which came accidentally under the influence of these strong magnets can injure or kill individuals in or nearby the magnet, or can seriously damage every hardware, the magnet itself, the cooling system, etc.. See MRI resources Accidents.
The doors leading to a magnet room should be closed at all times except when entering or exiting the room. Every person working in or entering the magnet room or adjacent rooms with a magnetic field has to be instructed about the dangers. This should include the patient, intensive-care staff, and maintenance-, service- and cleaning personnel, etc..
The 5 Gauss limit defines the 'safe' level of static magnetic field exposure. The value of the absorbed dose is fixed by the authorities to avoid heating of the patient's tissue and is defined by the specific absorption rate. Leads or wires that are used in the magnet bore during imaging procedures, should not form large-radius wire loops. Leg-to-leg and leg-to-arm skin contact should be prevented in order to avoid the risk of burning due to the generation of high current loops if the legs or arms are allowed to touch. The patient's skin should not be in contact with the inner bore of the magnet.
The outflow from cryogens like liquid helium is improbable during normal operation and not a real danger for patients.
The safety of MRI contrast agents is tested in drug trials and they have a high compatibility with very few side effects. The variations of the side effects and possible contraindications are similar to X-ray contrast medium, but very rare. In general, an adverse reaction increases with the quantity of the MRI contrast medium and also with the osmolarity of the compound.

See also 5 Gauss Fringe Field, 5 Gauss Line, Cardiac Risks, Cardiac Stent, dB/dt, Legal Requirements, Low Field MRI, Magnetohydrodynamic Effect, MR Compatibility, MR Guided Interventions, Claustrophobia, MRI Risks and Shielding.

MS-325 is the formerly code name of gadofosveset trisodium (new trade name Vasovist). MS-325 belongs to a new class of blood pool agents for magnetic resonance angiography (MRA) to diagnose vascular disease. Gadofosveset trisodium has ten times the signal-enhancing power of existing contrast agents as well as prolonged retention in the blood. This enables the rapid acquisition of high resolution MRA's using standard MRI machines.
Gadofosveset trisodium, which is gadolinium-based, stays in the blood stream as a result of transient binding to albumin. Albumin binding offers an additional benefit beyond localization in the blood pool. The contrast agent begins to spin much more slowly, at the rate albumin spins, causing a relaxivity gain that produces a substantially brighter signal than would be possible with freely circulating gadolinium. MS-325 is an intravascular contrast agent intended for use in MRI as an aid in diagnosing aortoiliac occlusive disease in patients with known or suspected peripheral vascular disease (PVD) or abdominal aortic aneurysm (AAA).
Currently clinical trials completed for peripheral vascular disease and coronary artery disease. Additional trials are also being conducted to evaluate MS-325 as an aid in diagnosing breast cancer and suggested that it might be feasible to combine the use of MS-325, injected during peak stress, with delayed high-resolution imaging to identify myocardial perfusion defects.
Vasovist (MS-325) would compete with the contrast agents Ferumoxytol (Code 7228) from AMAG Pharmaceuticals, Inc. and NC100150 Injection from Nycomed Amersham, but their further development is uncertain.
Partners in development: EPIX Pharmaceuticals, Inc., Mallinckrodt Inc., and Bayer Schering Pharma AG. Bayer Schering Pharma has the worldwide marketing rights for the product.
Formerly known under the Mallinckrodt trademark name, AngioMARK®.

See also Classifications, Characteristics, etc.